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Question

My wife suffers from severe pain mostly in her left knee. She went for an MRI scan and the conclusion was' Metastalic lesions in the spine.No cord compression is seen.Marked degenerative changesin the lumber spine with compression of right L4 and left L3 nerve root in the neural foramen. Prescription BUTRANS PATCH 20micrograms 1 per day. LANSOPRAZOLE 15mg 1 per day. NAPROXEN 250mg 1 twice per day. CO-CODAMOL 30mg+500mg 1-2 every 4-6 hours. ANASTROZ0LE 1mg 1 per day. SIMVASTATIN 20MG 1 per day. ASPRIN 75mg 1 per day. PERINDOPRIL ERBUMINE 2mg 1 per day. PREGABALIN 100mg 1 three times a day. ADCAL-D3chewable 2per day. Could you please advise if we would be able to gwt something done,because despite all this medication she is still suffering severe pain Kind Regsrds Mr N G Pollard for Mrs G M Pollard

Submitted: 36 days and 1 hours ago.
Category: Health
Value: $20
Status: CLOSED
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Posted by Dr. Ketch 36 days ago.

Answer

Dear Mr. Pollard:

 

Let me introduce myself. I am formerly a professor from the school of medicine at Yale University with a formal training in chronic pain management at Memorial Sloan Kettering Cancer Center. I am having some issues deciphering what is going on, partially because I believe there some key information you have left out and some things have been mis-spelled.

 

When you say metastalic, do you mean metastatic? Does your wife have breast cancer ? Have they done any x-rays of the knee?

 

I am afraid you have presented a very complex problem that may require some time and effort on my behalf to sort out and try to help your wife.

 

Dr. Ketch

35 days and 21 hours ago.

Reply

Metastatic is correct (sorry)

Breast cancer operation 17/3/99

Part of breast removed and seventeen lymph ? glands removed left side.

Stroke August 2002.

Fluid on lung November 2005. Drained ,okay since.

They took EX-Ray of the bottom of her spine and said she had arthritis ,and they said this was rhe cause of pain in knee.

Accepted Answer

Dear Mr. Pollard:

 

I am sure your wife has excellent doctors, I am not sure where you live and not going to question the caliber of those who she is under the care of. If she has a metastatic lesion in the spine, it would suffice it for me to think there may be metastatic lesions elsewhere.

 

You see, the wiring in our body is very much like the wiring in your house. The power comes from a power station, the brain, it is conducted by a main transmission wire, the spinal cord. Along the way it branches to homes, organs, arms legs. Okay we can say that there is a problem with the main wire to the house, is that all they did. I mean did they do a neurological exam? Did they look at the circuit breaker of the house to determine that the problem she is having in the bathroom lights is actually from the main line or did we look at the entire wiring in the house or bathroom, like from spine, through hip to the knee. I am thinking if she is having some issues at the level of the spinal cord, or the main branches of it, she should be experiencing other problems, weakness, abnormal sensation in the leg, or reflexes or pain in other parts of the leg. Kind of if there is a problem at the main power line, I would expect more than the lights in the bathroom to go out.

 

I am not comfortable with this single diagnosis of pain in the spine and let's brush it under the carpet with a whole lot of pain medication philosophy. Pain medications as far as I know mask the pain and do not actually solve the reason why she is in pain. I am under the suspicion that there is something else going on with the knee. I am not saying that those docs are not right, I am saying they may be right, but before we draw any conclusions, let's look into this knee pain to see if there is anything else going on. This is not a simple 19 dollar question, I am sure you realize that.

 

We are talking about the comfort of a woman who you love and care about and want to make sure that the quality of her life is going to be okay. By the way, have they discussed the seriousness and the significance of that metastatic lesion and what it means to you and your wife?

 

I think that what needs to be done next is further evaluation of this knee pain by examining, evaluating and X-raying that knee, second you and your wife need to make some quality of life choices, because if that thing in her spine is a metastatic lesion, then the cancer is back.

 

Please click on the GREEN ACCEPT button for me to receive credit for my work and for answering your question. I would appreciate positive feedback and bonus for the effort. Please do not hesitate to ask any questions for further clarification.

 

Dr. Ketch

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Expert: Dr. Ketch
Pos. Feedback: 100.0 %
Accepts: 
Answered: 10/17/2009

Doctor

Medical Degree, Former Assistant Professor at School of Medicine at Yale University

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